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"I have high cholesterol, but no one in my family has heart disease. Is my risk lower?"

While the likelihood you'll develop heart disease depends on a multitude of risk factors, you can take several steps to reduce your odds of being diagnosed with the disease that affects more than 81 million Americans and is the top killer of both men and women.

Uncontrollable heart disease risk factors

Family history. "Family history is one of the strongest heart disease risk factors, but it may not be that accurate," said Marshfield Clinic cardiologist Dr. Sanjay Kumar. Patients might not know a family member's true diagnosis or might not know their relative had a heart condition at all. To get a better picture of your risk, your health care provider will want to know how old family members were when they were diagnosed with heart disease or experienced cardiovascular problems.

Age. Heart disease risk increases as you age. Most people are diagnosed after age 60, but early stage disease can start around 40.

Gender. Men are at higher risk than women until women reach menopause, Kumar said. But because women's heart disease symptoms sometimes are atypical, diagnosis can be missed or delayed.

While you can't change your family history or stop the clock from ticking, Kumar said screenings like blood cholesterol tests starting in your 30s, at-home checks for elevated resting heart rate (above 90 for adults), and lifestyle modifications can lower your chances of developing heart disease. These steps can also help catch the disease in its early stages.

Risk factors you can change

Smoking. Smoking a pack of cigarettes a day doubles your chance of having a heart attack, but it's one of the most modifiable risk factors. Your doctor can help you make a smoking cessation plan.

High cholesterol, high blood pressure, high heart rate and diabetes. Total blood cholesterol greater than 180, blood pressure greater than 140/90, resting heart rate greater than 90 and type 2 diabetes could put you at increased risk for heart disease.

Weight. Exercising 30 minutes, five times a week, eating a healthful diet and taking appropriate medications prescribed by your doctor can help you reduce your heart disease risk factors and maintain a healthy weight.

Other medical conditions. Proper management of kidney disease and inflammatory conditions like rheumatoid arthritis and lupus can reduce the impact of these conditions on your heart, Kumar said.